Clinical trials of ibogaine, a psychoactive African herb reported
to rapidly reduce the symptoms of drug addiction withdrawal and allow
relatively painless detoxification, may begin in Cape Town next year.
With an estimated 40 000 heroin addicts alone in South Africa, publicity
given to ibogaine on the television programme Carte Blanche this May led
to desperate addicts clamouring for the herbal palliative – and to potential
for its increased unsupervised use. The hallucinogenic herb is unscheduled in
this country and can be obtained over the Internet or via innovative local
providers. Psychiatrist Greg McCarthy, the addiction expert and Medical Research
Council (MRC) consultant who wants to run the trials at the University of
Cape Town pharmacology department, said he received 40 enquiries within
3 days of the programme airing. ‘There’s desperation out there, but
without proper support structures the unsupervised use of any detoxification
agent can actually enable addiction,’ he warned.

He explained that by detoxifying people without holistic treatment, ‘you
say to the addict side of them “use again because you can get methodone,
subutex (buprenorphine) (detox drugs currently registered for use), or ibogaine
from anyone”’. McCarthy said no detoxification could
be termed addiction ‘treatment’ unless accompanied by proper preparation and
long-term monitoring and counselling of the addict to address underlying
problems and stressors, plus general health care.

A leading Miami University neurochemistry researcher, Dr Deborah Nash,
conducted 400 non-FDA approved ibogaine treatment episodes in the Caribbean. She found it ‘safe’
and said that it ‘took away almost unbearable withdrawal symptoms within an hour’.
It then sent the patient on a hallucinatory trip (of up to 36 hours)
‘during which life is reviewed in a kind of waking dream’, and finally took away the craving for several weeks.

Potential for wide application

Nash said the herb – an indole alkaloid derived from the root bark
of the African plant Tabernanthe iboga had shown efficacy for heroin users,
alcoholics and people addicted to psychostimulants like cocaine and
methamphetamine.
Unlike other detoxification agents, ibogaine is not just a Kappa opiate
replacement, it also acts on two
important neurotransmitters in the brain (NMDA and serotonin), giving it an
LSD-like action and it may stimulate the production of brain-derived
neurotrophic factor (BDNF).
McCarthy, a respected veteran of the Cape Town drug treatment circuit,
intends to recruit 100 recidivist heroin addicts and secure funding to conduct
a randomised trial comparing the wellestablished methadone/buprenorphine
detox regimen with ibogaine. He said the participants would get
the detox drugs/herb plus an outpatient addiction treatment programme,
which would include psychiatric and psychological follow-up, as well as selfhelp
support groups as a minimum. If funding could be found for a
formal outpatient addiction treatment programme, this would clearlybe
preferable. The initial detoxification, subject to departmental and ethical
approval, would take place in the well-equipped pharmokinetics room at
the University of Cape Town. This had DSTV, a lounge area, baths, showers,
beds and a pool table. Because it was on the Groote Schuur Hospital campus
there would be registrars on call, resuscitation equipment on hand and an
ICU nearby.
‘Success will be abstinence at one year,’ McCarthy declared, emphasising
that the number of participants and length of follow up beyond 12 months
would depend on funding.

Reduces detox time

Recently invited to serve on a top international study group for traditional
medicines in addiction treatment, McCarthy said he was ‘thoroughly
fascinated’ by the literature on ibogaine that he was asked to review
before appearing on the Carte Blanche programme. He was also bemused by
the lack of interest by treatment centres in a drug that may dramatically reduce
detoxification time. Patients who had a rapid and
relatively pain-free withdrawal were much more likely to engage in
treatment because they felt instant or immediate effects and experienced the
benefits of being on treatment. ‘When they wake up from their “trance” they
see their lives in a different way. If they can see themselves not as victims but as
agents of their own destiny then they are definitely ripe for rehabilitation,’ he added.
Dr Charles Parry, director of the MRC’s Drug and Alcohol Research
Unit, said of ibogaine and McCarthy’s intentions: ‘We’ve made no commitment
but we have an open mind and are in negotiations about the possibility of
working with him on clinical trials’.

Users ‘enthusiastic’

Izindaba tracked down Charles Rossouw, a retired pharmacist who has ‘devoted
his life’ to ibogaine after a personal ‘Damascus road-like’ experience with
it and encountering alcohol and drug problems in his own family. Rossouw
runs an unregistered drug addiction rehabilitation facility on a farm near
Rayton, 20 km north-east of Pretoria. He claims to have treated 52 people with
ibogaine ‘with no medical difficulties’, and boasts a 60% success rate.
McCarthy says the best rehabilitation centres in the world (the USA’s Betty
Ford Clinic and Amsterdam’s Jellinek Institute), using acknowledged
nonherbal ‘weaning’ drugs, claim a 40% success rate for abstinence at 1 year.
Rossouw decided to ‘go it alone’ after nearly 3 years of failed attempts to get
‘official help’ from treatment centres, the police, the Medicines Control
Council and the MRC. ‘The police
thought I might be up to something that’s not quite up to scratch – the word
hallucinogenic makes them immediately think of LSD whose banning I cannot
work out because it’s not habit forming.’

Although using ibogaine as a medicinewas illegal in this country,
‘I’m using it as a herb, as it comes from a natural source,’ Rossouw said.

‘I take care’ – amateur rehab man

He says that prior to deciding whether a patient is ibogaine-ready, he conducts
a stress ECG and does liver and kidney function tests and makes sure they
have very little of the drug that they last abused left in their system. ‘I keep
people here for a month and have enlisted the services of a qualified
counsellor with a strong psychology background. We keep (clients) occupied
and fed and give them time to work through what is a very spiritual
experience in a conducive environment.’ Rossouw explained that most
ibogaine users had a mystical experience similar to the original
traditional Africans who ‘met their ancestors’, and emerged understanding
and resolving the issues behind their addictive behaviour. An Izindaba
reading of users’ experiences posted on the Internet seemed to reflect this claim.
Rossouw, described by McCarthy as ‘highly irresponsible and actually
enabling addiction’, charges R12 000 for those clients ‘who only want to do it
for spiritual reasons and those already off drugs for a while’. His price for a
month-long detoxification ‘treatment’ is R18 000. He said that while it normally
took drug addicts up to 6 months to ‘break through’ their addiction, ibogaine
reduced this to 24 hours. McCarthy said he believed that the
Carte Blanche programme could be interpreted as his endorsing Rossouw’s
methods, when the opposite was true. ‘The current law says that if I
suspect a fellow doctor to be guilty of malpractice, I’m obliged to report it
or I could be charged with collusion. I wonder what the pharmacy board at the
HPCSA would say about a pharmacist with no training in drug abuse
treatment doing this?’ he asked. He illustrated his concern by saying
that ‘if someone has paranoid psychosis and you give them ibogaine, it may
cement the psychosis’. Rossouw said he felt threatened by
McCarthy. ‘He’s the first person that’s been interested in it (ibogaine) and now
seems to be the first person to want to steal it,’ he confessed.
Rossouw is currently ‘treating’ 5 clients after ‘a certain hospital’ in
Pretoria donated several beds to him, but has plans to expand his facilities
to cater for 18. ‘This has become my life and passion and I’ve given up everything to do it. I’ve treated
people from 15 to 55 years old and I love working with them. Often it’s
prostitutes, derelicts and people cast out by society. If I help one, it multiplies to
about 20 folk closest to them and that’s very satisfying,’ he says.
Like McCarthy, Rossouw was also unhappy with the Carte Blanche
programme (which interviewed several hard drug users live after they had
taken ibogaine). ‘They wanted to prove that it’s the magic bullet, which it’s not,’ he said.
• Heroin, along with benzodiazepines, the hardest of all drugs to wean
addicts from, has a street price of around R50 per quarter gram in
South Africa (almost a tenth of its UK street price) and is usually sniffed
or smoked here. Its local usage has recently seen an alarming increase.

Hi Jakob
Yes that article is about me.
Just to update you on the research - there is something
in the pipeline, which I shall tell you about in the near future.
Thank you for adding our website to yours. I will do the same on our side
and ask our ISP webdesigner to add your link.
By the way - it could be worth your while to investigate us as an
alternative to the European venues. Our cost is reasonable campared to
them, and airline tickets are not expensive. ( From Frankfurt or Amsterdam
it is about 900 Euro, depending on time. Our cost comes to under 1500Euro,
and the person stays with us for two weeks, during which he/she may
participate in various activities. The food is first class (No wine with
dinner, unfortunately, and no smoking dope while they are here), and the
place is clean and comfortable. Although we work in a very informal, homely
way, we provide a safe environment during the treatment phase. We believe a
clinical backdrop is not ideal, especially during the visionary parts of an
Ibogaine experience. Our success rate also measures up to the rest of the
world, and is improving all the time, as we are improving our counselling
techniques and skills and other services that we provide. Kevin (my working
partner) and I will be glad and honoured to answer any questions that
someone from Sweden may ask.
Anyway - You really did your homework well if you found the article on me
and I must congratulate you again on a good website.
Kind regards
Charles

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